浙江省某县疾病应急救助制度运行情况调查

Investigation on the operation of disease emergency rescue system in a county in Zhejiang Province

目的了解疾病应急救助制度的实施效果、存在问题,提出改进措施。方法收集浙江省某县级市实施疾病应急救助制度以来2015年至2019年病例资料,统计每年救助人次、救助经费、医疗费用和救助对象特征等指标,分析实施效果及问题;召集相关管理部门及医院领导、医生及相关管理人员进行座谈,了解工作中的困难和问题。结果该县级市年均救助患者1260人次,年救助经费支出200.73万元,占总医疗费用的79.81%。救助对象以无力支付、男性、15~60岁的患者为主。平均住院天数为16.42天,住院日超过3天者占所有救助住院患者的65.20%。制度实施过程中存在救助对象认定难、患者滞留医院等问题。结论疾病应急救助制度取得了明显成效,救助了大量无力支付的男性青壮年劳动力,但还应进一步优化顶层设计,完善相关机制;减轻医疗机构负担并规范医疗行为;进一步规范救助基金的使用;建立疾病应急救助信息平台;加强宣传教育,促进制度有效落实。

Objective To understand the implementation effect and problems of disease emergency rescue system,and put forward improvement measures.Methods The case data of a county-level city in Zhejiang Province from 2015 to 2019 were collected,and the annual rescue person times,rescue funds,medical expenses and the characteristics of rescue objects were counted,and the implementation effect and problems were analyzed.Symposiums were held with relevant management departments and hospital leaders,doctors and other relevant management personnel.Results Every year the county rescued 1260 patients,and the rescue expenditure was 2.0073 million yuan,accounting for 79.81%of the total medical expenses.The main objects of assistance were the patients who were unable to pay,male,15-60 years old.The average length of stay was 16.42 days,and those with more than 3 days of stay accounted for 65.20%of all hospitalized rescued patients.There were some problems in the implementation of the system,such as difficult to identify the relief object,patients′stranding in the hospital and so on.Conclusions The disease emergency rescue system has achieved significant results,helping a large number of male laborers who cannot afford to pay.We should further optimize the top-level design and improve the relevant mechanism;reduce the burden of medical institutions and standardize medical behavior;further standardize the use of rescue funds;establish an information platform for disease emergency relief;strengthen publicity and education to promote the effective implementation of the system.